Cardiovascular disease, the leading cause of death in the United States, has roots in childhood with the establishment of behaviors which lead to increased CVD risk. The Healthy Start Trial (Cardiovascular Risk Reduction in Minority Preschool Children, 1995-1998) is testing the effectiveness of nutrition interventions (food service change and a preschool nutrition curriculum) on blood cholesterol and diet among preschool children (age 3-5 years) attending Head Start Centers in upstate New York. Preliminary results indicate that the results are favorable, with significant effects on blood cholesterol, diet and menu content (percent energy from total and saturated fat). The continuation proposes to extend measurement of the Healthy Start Cohort through 8 years of age. The study will examine hypotheses related to a) long term intervention effects (blood cholesterol, dietary total and saturated fat, nutrition knowledge); b) tracking of lipids, blood pressure, obesity, and growth velocity from age 3 to 8; c) preschool intentions to smoke cigarettes, parental smoking, and early experimentation in elementary school; and d) long term maintenance of nutrition intervention activities in participating Head Start Centers. The study cohort consists of 1786 children who completed one or two full years of preschool intervention. The cohort is low income, 42 percent Black, 31 percent Hispanic, 23 percent White, 4 percent other. Uniform measurement methods will be employed during the continuation to assure comparability with data collection during the preschool period. These measures will include: a) blood lipids; b) blood pressure and resting heart rate; c) height and weight; d) triceps, subscapular and suprailiac skinfold measurements; e) waist and hip circumference; f) health and nutrition knowledge, attitude and self-reported behavior questionnaire (including smoking); g) 24-hour dietary recall, h) family history of CVD.